The controversy surrounding the possible causes of chronic fatigue syndrome (CFS) resurfaced this month, after results published in the Archives of Paediatrics and Adolescent Medicine showed that children with the disease had higher levels of oxidative stress and white blood cell apoptosis than controls—findings suggesting that the children with CFS are fighting a viral infection.

There is a general consensus that CFS is a heterogeneous family of disorders, and it seems most likely that these disorders arise from a constellation of pathophysiological causes.

We weten het dus nog niet

Samenvattend concludeert de editor:

The results in the Archives of Paediatrics and Adolescent Medicine received great media attention. But they do not prove that CFS is a physical disease. CFS is still far from being a well-defined entity. When the totality of available evidence is considered, the uncertainty around our understanding of the physical–psychological interaction taking place in patients with CFS only strengthens the case for giving research into chronic fatigue the high priority it deserves.

“there is evidence of persistent enterovirus RNA in ME/CFS patients; there is evidence of abnormalities in the 2â€5 synthetase / RNase L antiviral pathway, with novel evidence of a 37 kDa binding protein not reported in healthy subjects or in other diseases; there is evidence of reverse transcriptase, an enzyme produced by retrovirus activity, with retroviruses being the most powerful producers of interferon; there is evidence of the presence of HHVâ€6, HHVâ€8, EBV, CMV, Mycoplasma species, Chlamydia species and Coxsackie virus in the spinal fluid of some ME/CFS patients, the authors commenting that it was surprising to find such a high yield of infectious agents on cell free specimens of spinal fluid that had not been centrifuged; recently a direct link between a gammaretrovirus (XMRV, which is the same family as the AIDS virus) and ME/CFS has been demonstrated”